慢性化脓性中耳炎围手术期应用抗生素的前瞻性研究

目的探讨慢性化脓性中耳炎围手术期抗菌药物应用的合理性,为规范应用抗生素提供理论参考。方法对术前处于静止期的160例手术治疗的慢性化脓性中耳炎患者进行前瞻性分析。根据围手术期使用抗生素的时间随机分为预防用药组(术前30 min及术后第1天应用抗生素)及治疗用药组(术后7 d应用抗生素)。记录其围手术期中耳或外耳分泌物微生物培养、药敏情况、白细胞计数和降钙素原数值。分别于术后1周复查,同时比较两组患者的术后感染率。结果预防用药组者术后感染率为1.25%,治疗用药组感染率为2.50%。两组细菌、真菌的检出率分布以及白细胞计数分布无显著性差异(P>0.05)。结论对于中耳分泌物培养提示无菌生长、单纯真菌生长或对头孢唑啉敏感菌种的慢性化脓性中耳炎患者,选择围手术期预防性应用抗生素2 d可以有效地控制手术部位的感染。

Prospective study of antibiotics in perioperative period of chronic suppurative otitis media

Objective To explore the reasonable application of prophylactic antibiotics in chronic suppurative otitis media operation.Methods Medical records of patients who underwent tympanoplasty±mastoidectomy for chronic suppurative otitis medisa were reviewed.Totally 160 patients with chronic suppurative otitis media were randomly divided into preventive medicine group and treatment group.A series of data including the postoperative infection rate,the pus cultivation and drug sensitivity test,serum procalcitonin(PCT)and white blood cell(WBC)have been collected before and after surgical treatment.Results The infection rate of preventive medicine group was 1.25%,the infection rate of treatment group was 2.5%.There was no significant differences in the distribution of bacteria,WBC counts and PCT in the two groups(P>0.05).Conclusion Administration of preoperative antibiotics for 2 days may prevent surgical site infections with tympanoplasty±mastoidectomy for chronic suppurative otitis media.